Controlling a phacoemulsification system based on real-time analysis of image data

ABSTRACT

A design for dynamically adjusting parameters applied to a surgical instrument, such as an ocular surgical instrument, is presented. The method includes detecting surgical events from image data collected by a surgical microscope focused on an ocular surgical procedure, establishing a desired response for each detected surgical event, delivering the desired response to the ocular surgical instrument as a set of software instructions, and altering the surgical procedure based on the desired response received as the set of software instructions.

This application claims priority to and is a divisional of U.S.application Ser. No. 14/147,213, filed Jan. 3, 2014, which is adivisional application and claims priority to U.S. application Ser. No.12/135,734, entitled “Controlling a Phacoemulsification System Based onReal-Time Analysis of Image Data”, filed on Jun. 9, 2008, the entirecontents of which are hereby incorporated by reference in their entiretyfor all purposes as if fully set forth herein.

BACKGROUND OF THE INVENTION

Field of the Invention

The present invention relates generally to the field of ocular surgery,and more specifically to real-time control of a medical instrumentsystem during ophthalmic procedures based on detected surgical events.

Description of the Related Art

Ocular surgery, such as phacoemulsification surgery, requires a surgeonto continuously make decisions while conducting the surgical procedure.To make these decisions, the surgeon may rely on a variety ofinformation originating within the surgical theater environment, whichmay include the surgeon using her auditory, tactile, and visual sensesto ascertain cues during the procedure. The surgeon may use theseenvironmental cues to make decisions regarding adjusting and refiningthe settings and parameters controlling the medical instrument system tobest perform the most effective, efficient and safest possible surgicalprocedure. One example of an environmental cue is reporting an audiblealarm to inform the surgeon that the instrument logic has detected aparameter, such as flow for example, has reached a value outside of adesired operating range.

Medical instrument systems incorporate numerous sensors to detect andcollect information from the surgical theater environment sensors andprovide this information as input to software programs that monitor themedical instrument system. Together with advancements in sensortechnologies, surgical monitoring software programs continue to evolveto take advantage of advanced sensor capabilities. One example of thecurrent state of software sensor state of the art is Advanced MedicalOptics' “occlusion mode” functionality provided in certainphacoemulsification systems, wherein a control program monitors vacuumsensors and recognizes vacuum levels exceeding a particular value. Oncethe control program detects that vacuum levels have exceeded the value,the control program adjusts system parameters accordingly.

The current state of the art also entails capturing optical imagesduring the surgical procedure and presenting these optical images withthe various instrument settings and sensor readings. One example of sucha design is Advanced Medical Optics' “Surgical Media Center,” aspects ofwhich are reflected in U.S. patent application Ser. No. 11/953,229,“DIGITAL VIDEO CAPTURE SYSTEM AND METHOD WITH CUSTOMIZABLE GRAPHICALOVERLAY,” inventors Wayne Wong, et al., filed Dec. 10, 2007 (issued asU.S. Pat. No. 8,982,195 on Mar. 17, 2015), the entirety of which isincorporated herein by reference. The Surgical Media Center providessimultaneous replay of surgical camera video images synchronized withmedical instrument system settings and parameters. Video and systemsettings information can be communicated to other systems andsubsystems. Another system related to capturing of optical images,specifically eye position, is reflected in the U.S. Pat. No. 7,044,602to Chernyak, U.S. Pat. No. 7,261,415 to Chernyak, and U.S. Pat. No.7,040,759 to Chernyak et al., each assigned to VISX, Incorporated ofSanta Clara, Calif.

Phacoemulsification instrument systems manufacturers provide productsthat allow the sensors within the systems to detect information from thesurgical environment and pass that data to control programs in order todynamically generate responses and adjust instrument system settings. Inconjunction, manufacturers continue to evolve and improve data analysisprograms to recognize certain patterns of information reported fromdigital video camera imaging data. Image analysis techniques may affordthe system the ability to perceive small changes or complex patternsotherwise undetected by a surgeon operating a surgical microscope.Important visual information or cues previously unavailable during asurgical procedure can now be employed during the procedure.

Ocular surgical procedures in particular, including phacoemulsification,involve manual procedures selected by the surgeon based on environmentalcues originating from instrument sensors. While manual procedures areeffective and in wide use, current surgical procedures can bechallenging in a surgical environment due to human response time and theability to perceive very small changes or very complex patterns withinenvironmental cues. It can be difficult for the surgeon to observeavailable environmental cues, and appropriately respond to these‘events’ quickly and accurately by determining and manually implementingnew settings and parameters to adjust the surgical instrument. Enhancinga surgeon's ability to perform the surgical procedure is alwaysadvantageous.

Based on the foregoing, it would be advantageous to provide for a systemand method that enhances the ability of the system to accurately detect,report, and quickly respond to surgical events from imaging data, andprovide information relating environmental changes previously notperceived by the surgeon for use in medical instrument systems thatovercomes drawbacks present in previously known designs.

SUMMARY OF THE INVENTION

According to one aspect of the present design, there is provided anapparatus configured to control parameters of a surgical instrumentemployable in a surgical procedure, such as an ocular surgicalprocedure. The apparatus comprises an image analysis module configuredto detect surgical events within an image data stream and an instrumentcontrol module configured to receive surgical events detected from atleast the image analysis module and generate responses to said detectedsurgical events. The instrument control module is configured to processsaid responses and transmit processed responses in the form of aninstruction set. The surgical instrument is configured to receive andexecute instruction sets communicated from the instrument control moduleduring the surgical procedure.

According to another aspect of the present design, there is provided amethod for dynamically adjusting parameters applied to a surgicalinstrument, such as an ocular surgical instrument. The method includesdetecting surgical events from image data collected by a surgicalmicroscope focused on an ocular surgical procedure, establishing adesired response for each detected surgical event, delivering thedesired response to the ocular surgical instrument as a set of softwareinstructions, and altering the surgical procedure based on the desiredresponse received as the set of software instructions.

These and other advantages of the present invention will become apparentto those skilled in the art from the following detailed description ofthe invention and the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention is illustrated by way of example, and not by wayof limitation, in the figures of the accompanying drawings in which:

FIG. 1 illustrates an exemplary phacoemulsification/vitrectomy system ina functional block diagram to show the components and interfaces for asafety critical medical instrument system that may be employed inaccordance with an aspect of the present invention;

FIG. 2 illustrates an exemplary surgical system in a functional blockdiagram to show the components and interfaces for a real-time digitalimage capture and presentation system that may be employed in accordancewith an aspect of the present invention;

FIG. 3 is a functional block diagram illustrating components and devicesfor a phacoemulsification instrument control module integrated withinthe surgical system for real-time surgical instrument control based ondetected surgical events in accordance with an aspect of the presentinvention;

FIG. 4 is a functional block diagram illustrating components for animage analysis software module for detecting surgical events fromdigital imaging data in accordance with an aspect of the presentinvention;

FIG. 5 is a functional block diagram illustrating components for aninstrument monitoring software module for detecting surgical events frominstrument sensor data in accordance with another aspect of the presentinvention; and

FIG. 6 is a functional block diagram illustrating components for aninstrument control software module for assigning an appropriate responseto detected events in accordance with another aspect of the presentinvention.

DETAILED DESCRIPTION OF THE INVENTION

The following description and the drawings illustrate specificembodiments sufficient to enable those skilled in the art to practicethe system and method described. Other embodiments may incorporatestructural, logical, process and other changes. Examples merely typifypossible variations. Individual components and functions are generallyoptional unless explicitly required, and the sequence of operations mayvary. Portions and features of some embodiments may be included in orsubstituted for those of others.

The present design is directed to mechanized control for adjustingsurgical instrument settings and/or parameters, e.g. vacuum, aspiration,etc., based on detected surgical events originating within the surgicaloperating theater environment. The present design arrangement mayinclude an image analysis component configured to recognize and reportsurgical events determined from the imaging data, such as imaging datareceived from a camera or via a surgical microscope. The arrangementtypically includes an instrument sensor monitoring and analysiscomponent configured to recognize and report surgical events determinedfrom instrument sensor data. In addition, the arrangement may include asurgical instrument controller configured to generate and transmitresponses instructing the surgical instrument to adjust specificsettings and/or parameters and alter the course of the remainingsurgery. The present design thus provides for dynamic or real-timecontrol of the medical instrument system and/or medical or surgicalinstrument.

In short, the present design provides for real-time control of themedical instrument system, affording alterations to the course of theremaining surgical procedure, realized from real-time analysis of videoimaging data. Analysis of the imaging data is typically automated orautomatic, i.e. requires zero or minimal user interface. Analysis ofinstrument sensor data may be employed separately or in combination withimage data processing to detect surgical events.

Any type of system or software application configured to receivedetected events from imaging and sensor data analysis, for example apilotless flight control application, may benefit from the designpresented herein, and such a design is not limited to aphacoemulsification system, surgical system, or even a medical system.The present design may be implemented in, for example, systems includingbut not limited to phacoemulsification-vitrectomy systems, vitrectomysystems, dental systems, industrial applications, and aerospaceapplications.

The present design may include a graphical user interface to furthercontrol automated operations and may include configuration and setupfunctionality. The system can provide the ability to assign variouspredetermined settings and parameters in response to specific detectedsurgical events and show video and instrument sensor data.

The present design is intended to provide a reliable, noninvasive, andefficient automatic control mechanism for a medical instrument systemfor use in dynamically controlling the surgical instrument system inreal-time.

System Example

While the present design may be used in various environments andapplications, it will be discussed herein with a particular emphasis ona medical or hospital environment, where a surgeon or health carepractitioner performs. For example, one embodiment of the present designis in or with a phacoemulsification surgical system that comprises anindependent graphical user interface (GUI) host module, an instrumenthost module, a GUI device, and a controller module, such as a footswitch, to control the surgical system.

FIG. 1 illustrates an exemplary phacoemulsification/vitrectomy system100 in a functional block diagram to show the components and interfacesfor a safety critical medical instrument system that may be employed inaccordance with an aspect of the present invention. A serialcommunication cable 103 connects GUI host 101 module and instrument host102 module for the purposes of controlling the surgical instrument host102 by the GUI host 101. Instrument host 102 may be considered acomputational device in the arrangement shown, but other arrangementsare possible. An interface communications cable 120 is connected toinstrument host 102 module for distributing instrument sensor data 121,and may include distribution of instrument settings and parametersinformation, to other systems, subsystems and modules within andexternal to instrument host 102 module. Although shown connected to theinstrument host 102 module, interface communications cable 120 may beconnected or realized on any other subsystem (not shown) that couldaccommodate such an interface device able to distribute the respectivedata.

A switch module associated with foot pedal 104 may transmit controlsignals relating internal physical and virtual switch positioninformation as input to the instrument host 102 over serialcommunications cable 105. Instrument host 102 may provide a databasefile system for storing configuration parameter values, programs, andother data saved in a storage device (not shown). In addition, thedatabase file system may be realized on the GUI host 101 or any othersubsystem (not shown) that could accommodate such a file system.

The phacoemulsification/vitrectomy system 100 has a handpiece 110 thatincludes a needle and electrical means, typically a piezoelectriccrystal, for ultrasonically vibrating the needle. The instrument host102 supplies power on line 111 to a phacoemulsification/vitrectomyhandpiece 110. An irrigation fluid source 112 can be fluidly coupled tohandpiece 110 through line 113. The irrigation fluid and ultrasonicpower are applied by handpiece 110 to a patient's eye, or affected areaor region, indicated diagrammatically by block 114. Alternatively, theirrigation source may be routed to eye 114 through a separate pathwayindependent of the handpiece. Aspiration is provided to eye 114 by theinstrument host 102 pump (not shown), such as a peristaltic pump,through lines 115 and 116. A switch 117 disposed on handpiece 110 may beutilized to enable a surgeon/operator to select an amplitude ofelectrical pulses to the handpiece via the instrument host and GUI host.Any suitable input device, such as for example, a foot pedal 104 switchmay be utilized in lieu of switch 117.

In combination with phacoemulsification system 100, the present designsurgical system includes image processing in or with thephacoemulsification system and may comprise a surgical microscope,digital video cameras, data storage, video rendering, and user interfaceto control the image capture and analysis system.

FIG. 2 illustrates an exemplary surgical system 200 in a functionalblock diagram to show the components and interfaces for a real-timedigital image capture, distribution, and presentation system that may beemployed in accordance with an aspect of the present invention. Thesurgical system digital image processing design will be discussed hereinbased on Advanced Medical Optic's surgical media center features andfunctionality.

Surgical system 200 may include a surgical instrument, for examplephacoemulsification instrument 102, such as thephacoemulsification/vitrectomy system 100 shown in FIG. 1. Surgicalsystem 200 may further include a surgical microscope 202 focused on thesurgical procedure, e.g. patients eye, and may involve digital videocameras 203, or other device suitable for video recording, and maytransfer the resulting image data at 204, in analog or digital form, tosurgical media center 205 via communications cable 206. Surgical mediacenter 205 is a processing device that manages the multimedia datarecorded by the surgical microscope, and the instrument sensor data 121in real-time, including but not limited to vacuum, power, flow, and footpedal position generated from phacoemulsification instrument 102 duringthe surgical procedure. Managing the multimedia data includessynchronizing the temporal relationship between the instrumentparameters, settings, and sensor data from phaco instrument 102 and theoptical data from surgical microscope 202. In this arrangement, system200 may communicate the digital video as an image data stream,representing the optical data from the procedure/surgery, with themedical system instrument parameters, settings, and sensor data reportedby phaco instrument 102 in real-time to other systems and subsystems.

The surgical media center may further include a digital video storagedevice 207 configured to store the multimedia data recorded. Videostorage device 207 may connect to and be accessed by surgical mediacenter 205 via communications cable 208. In addition, a video displaydevice 209 may connect to surgical media center 205 and digital videostorage device 207 via communications cable 208.

In this configuration, surgical media center 205 may record and presenta video image of the procedure/surgery with the medical systeminstrument parameters and settings utilized by the phacoemulsificationinstrument 102 in real-time. Surgical media center 205 may synchronizeinstrument data with the video stream allowing simultaneous display ofvideo data with a graphical overlay showing the corresponding parametersand system settings at each instant of the procedure on a frame-by-framebasis. This cumulative data, i.e. the video data synchronized with thesetting and parameter data may be stored and archived in digital videostorage device 207. During playback, the user may select to show or hidedifferent elements of the instrument data rendered on video displaydevice 209.

Event Detection and Instrument Control

The present design typically includes a real-time surgical instrumentcontrol module configured to receive detected surgical events anddynamically adjust instrument parameters and settings to alter thecourse of the remaining surgery. Detected surgical events may originatefrom image analysis software, instrument sensor monitoring software, andother software components configured to analyze information collectedfrom the surgical environment. The detected surgical events, includingbut not limited to commencements of procedures, termination ofprocedures, changes in system or patient parameters such as pressureapplied, pressure available, patient blood pressure, patienttemperature, instrument temperature, and so forth, may be electronicallycommunicated to the instrument control module for matching anappropriate response to received events and sending the response(s) tothe surgical instrument. The response may include commands orinstructions containing information relaying adjustments or changes toin-effect instrument settings and parameters.

System

FIG. 3 is a functional block diagram illustrating components and devicesfor an instrument monitor 301 module with an instrument control module302 integrated within surgical system 200 for real-time surgicalinstrument control based on detected surgical events in accordance withan aspect of the present invention. From FIG. 3, a surgical microscopeconfigured to capture an optical image of the eye requiring surgery maycommunicate the optical images to more than one digital video cameras203. In this arrangement, digital video cameras 203 may convert theoptical images received into video images, such as for example a digitalimage data stream, and provide data streams to one or more imageanalysis 303 modules. Image analysis 303 module may analyze the digitalimage data streams using ‘logic’ configured to detect imaging specificsurgical events 305.

In conjunction with the image data streams analysis, phaco instrumentmonitoring 301 module may analyze data reported from multiple sensorsusing ‘logic’ configured to detect sensor reported specific surgicalevents 306. The present design may communicate detected surgical events305 and 306 from the image analysis 303 module and from the phacoinstrument monitoring 301 module, respectively, in real-time to phacoinstrument control module 302. The phaco instrument control modulearrangement may be configured to receive and process data and dataanalysis information realized from software programs configured todetected surgical events. The processing ‘logic’ may determine from thisdata appropriate changes to various parameters and settings for phacoinstrument 102 such that implementing these changes may alter the courseof the remaining surgery.

The present design may communicate changes for instrument settings andparameters from phaco instrument control 303 module to phaco instrument102 for modifying the behavior of the surgical instrument and associatedhandpiece 114 in real-time. Examples of settings and parametersavailable for real-time modification include, but are not limited tocontrolling: pulse rate and waveform, rate of fluid dispensing, vacuum,aspiration, cutting speed, and combinations thereof.

During an ophthalmic surgical procedure, a surgeon may operate surgicalmicroscope 202 to render optical images of the surgical site. Thesurgical microscope may include one or more digital cameras configuredto convert the optical images of the surgical site into a stream ofdigital image data. The digital camera(s) may communicate or deliver thedata stream(s) to one or more image analysis 303 modules for processing.Data processing may involve ‘logic’ configured to detect and reportspecific surgical events. For example, one image analysis softwarecomponent may involve an edge detection capabilities and another imageanalysis software component may involve pattern recognition techniques.The present design may involve these techniques to provide informationfrom imaging data previously not available to the surgeon.

The image analysis software may be arranged to accept input from one ormore digital cameras. Multiple camera configurations may be positionedto provide for greater depth perception realized by 3D imagingtechniques or positioned to provide for multiple viewing anglesaffording a more complete set of image data. Multiple cameraconfigurations may be arranged to collect non-visible wavelengths suchas ultra-violet and infrared and convolve this information with visiblewavelength information within the optical images to form a more completespectrum of light analysis and thus gaining access to new informationavailable for imaging analysis.

In conjunction with operating the surgical microscope to observe theophthalmic procedure, the surgeon may operate phacoemulsificationinstrument system 102 to perform activities to complete the procedure.

The present design may include one or more software programs arranged tomonitor instrument sensors and to control the instrument. Referring toFIG. 3, phaco instrument monitoring 301 module may be configured tomonitor each sensor incorporated in or with the phaco instrument. Phacoinstrument control module 302 may be configured to provide anappropriate response 304, in real-time, sufficient for dynamicallyaltering the operating settings and parameters of phaco-instrument 102appropriately when specific surgical events are detected. Theappropriate responses to a detected surgical event may vary depending onthe nature and type of event detected. Appropriate response 304 mayinclude but is not limited to an auditory signal emitted to alert thesurgeon, adjusting an operating parameter such as vacuum or fluid flow,and shutdown of the entire system.

Phaco instrument monitoring 301 module may contain logic identifyingwhen specific surgical events occur based upon recognition ofpredetermined patterns of readings from a sensor or multiple sensors.

Phaco instrument control module 302 may receive continuous andsimultaneous communication of surgical events 305 originating from anddetected by the image analysis and surgical events 306 originating fromand detected by the instrument monitoring module. The present design maybe configured to dynamically modify the phaco instrument operatingsettings and parameters in a predefined manner; affecting a change inthe course of the remaining surgery for realizing a safer and moreeffective ocular procedure. The system may continuously update settingsand operating parameters, in an iterative manner, to remove activelyreported events. The continuous update may involve a feedbackarrangement that continuously adjusts the system until the detectedevent is addressed or the system is shut-down. In this feedbackarrangement, the present design may continue to adjust a parameter orother surgical event, reported out of range, until the event is removedby the parameter being restored to an acceptable in range value. Thepresent arrangement may correlate surgical events detected by imageanalysis and instrument monitoring software for determining if they arethe same event being detected and reported, or if they are unrelatedevents.

In another embodiment, the present design may provide information to theimage analysis module for accurate imaging event detection. For example,the image analysis component logic may benefit from knowing thecurrently selected ‘in-use’ instrument operating parameters to functioncorrectly. While depicted as multiple elements, the present designsimage analysis 303, instrument monitoring 301, and instrument controlmodule 302 software may alternatively comprise one or more distributedsoftware modules or entities and may be realized in hardware, software,firmware, and any combinations thereof to fulfill the functionality thedisclosed software programs.

FIG. 4 is a functional block diagram illustrating components for animage analysis 303 module for detecting surgical events from digitalimaging data in accordance with an aspect of the present invention.Three software components are illustrated within the image analysismodule. The present design may include a pattern recognition 401component configured to analyze the image data streams for predefineddata patterns. One potential pattern recognition logic design forextracting desired patterns from image data suitable for use in thecurrent context is disclosed in “Pattern Recognition Systems andMethods”, inventor Shashidhar Sathyanarayana, U.S. Patent Publication2006/0159319, published Jul. 20, 2006, the entirety of which isincorporated herein by reference.

The present design may also include an edge detection component 402configured to analyze the image data streams for detecting edges of oneor more objects within the imaging data. One example of edge detectionlogic for determining the location of at least one edge of an objectfrom image data suitable for use in the current system is disclosed in“System And Method For Edge Detection of an Image”, inventor ShashidharSathyanarayana, U.S. Patent Publication 2004/0146201, published Jul. 29,2004, the entirety of which is incorporated herein by reference.

The apparatus and method may include an infrared wavelength analysiscomponent 403 for extracting information from the invisible portion oflight spectrum. A stereoscopic imaging component 404 may combine edgedetection, pattern recognition, ultra violet and other functionalityarranged to analyze multiple data streams rendering stereoscopic contentfor detecting surgical events realized within multiple views of thesurgical procedure. Although illustrated with three software components,image analysis module 303 may comprise additional components directed atrecovering other types of information from image data 204 for thepurpose of generating additional detected events at point 305. The edgedetection component 402 may configure the pattern recognition and edgedetection algorithms to identify one or more ocular objects of surgicalinterest, such as a cataract.

FIG. 5 is a functional block diagram illustrating components for aninstrument monitoring module 301 that detects surgical events frominstrument sensor data. The present design may include a vacuum sensoranalysis component 501 configured to analyze and monitor vacuum relatedinformation from sensor data 201. Vacuum sensor analysis component 501may monitor sensor data 201 to determine when the actual vacuum pressurereported by the sensor is within a predetermined range of acceptablevalues associated with the current stage of the ocular procedure. In thesituation where the actual value reported exceeds or drops below theexpected predetermined range, the present design may generate detectedevent 306 to indicate such a change has occurred.

The present design may include a pressure sensor analysis component 502configured to analyze and monitor pressure related information fromsensor data 201. Pressure analysis 502 may monitor sensor data 201 fordetermining if the actual pressure reported by the sensors remainswithin a predetermined range of values associated with the particularstage of the ocular procedure. In the situation where the actual valuereported exceeds or drops below the predetermined range, the presentdesign may generate another detected event 306 to indicate this changein pressure.

In a similar manner, a third instrument monitoring component isillustrated at point 503 and may be configured to determine whethermultiple sensors reported by the surgical instrument remain within adesired range. Although illustrated with three analysis components,instrument monitoring 301 software module may comprise additionalcomponents directed at recovering other types of information from sensordata 201 for the purpose of detecting additional events 306.

FIG. 6 is a functional block diagram illustrating components for aninstrument control 302 module to assign an appropriate response 304 todetected events 305 and 306. The present design may include an imageevent response 601 component configured to receive detected events 305from image analysis module 303 and translate each received event into anappropriate response 304. The present design may include a sensor eventresponse component 602 configured to receive detected events 306 fromthe instrument monitoring module 301 and translate each received eventinto an appropriate response 304.

In both situations, detected event translation may involve assigningeach event type a response. Each response may be converted or mapped toa predetermined set of software instructions. Instrument control module302 may communicate commands at point 604, responsive to each detectedevent received, to instrument system 100 as an appropriate response 304.The communicated commands and sets of instructions may be received andexecuted by instrument system 100 for adjusting control of instrumenthost 102.

A correlated event response component 603 may be provided to receiveboth image and sensor detected events. Correlated event response 603 mayinvolve comparing the received detected events for determining whetherthey represent the same or different surgical events. In the situationwhere the detected image and data event types originate from the samesurgical event, the present design may assign a further appropriateresponse in a manner as previously described for correlated events, ormay cancel any duplicate responses originating from and associated withthe same surgical event.

User Interface

A user interface device executing within surgical system 200 maycommunicate with and enable control of the image analysis, sensormonitoring, and instrument control software for configuration andoperational control of the present design's real-time surgical eventdetection and response automated mode. The user interface device mayinclude, but is not limited to, a touch screen monitor, mouse, keypad,foot pedal switch, and/or a computer monitor. The system 200 typicallyincludes algorithms, tables, and data relating desired response todetected surgical event(s). The algorithms and data may be residentwithin surgical system 200 or realized using external devices and/orsoftware. Graphical user interfaces are generally known in the art, andthe graphical user interface may provide, for example, touch screen orbutton to enable/disable automated instrument control and select from aset of operational mode(s) by the user touching the screen or pressingbuttons on the interface. Other user interfaces may be provided, such asa selection device including but not limited to a foot pedal switch asdiscussed.

The user interface device enables the user to select system features,set system parameters, turn functionality on and off, and so forth. Asnoted, such a graphical user interface may be known in the art and canbe engaged by touching the screen, pressing buttons, turning dials, andso forth.

Operational Use

The present design may adjust instrument settings and parameters basedon stored predetermined responses assigned to the particular detectedsurgical event, either automatically or with user input. For example,the image pattern recognition facility may detect the presence of acataract and determine the density of the detected cataract. The imagepattern recognition facility may communicate cataract densityinformation, in real-time, to the instrument control program. Theinstrument control software may assign a tailored set of instructionsbased on the received cataract density information and communicate theset of instructions for real-time execution by the phacoemulsificationinstrument affecting control of the surgical procedure in the event of acataract having the specific density encountered. Real-time altering ofinstrument settings and parameters in this way may enable the surgeon tocontinue performing the surgical procedure efficiently, i.e. withoutinterruption to manually adjust the instrument controls.

In another example, the image pattern recognition facility configurationmay detect the presence of a capsular bag and determine the bag'scondition, e.g. good, weak, or broken. The capsular bag information maybe communicated from the image pattern recognition facility, inreal-time, to the instrument control program. The instrument controlprogram may be configured to assign an immediate phaco“stop-instruction” in the situation when either a weak or brokencapsular bag condition is detected. In the situation where a weak orbroken capsular bag is indicated, the present design may communicate the“stop-instruction” to the phacoemulsification instrument for real-timeexecution. Stopping the instrument in this way may prevent surgicalcomplications and enable the surgeon to complete the procedure in a safemanner.

Further examples may include the image analysis software configured todetect a large number of similar surgical events. In this configuration,the present design may allow for assignment of a large number or patternof similar detected events to a response, such as repeated encounters ofexcess pressure readings during normal operation, thus affording furtherrefinement in the instruction sets available for controlling thesurgical system.

In sum, the present design provides an ability to control parameters ofa surgical instrument employed in a surgical procedure, such as anocular surgical procedure. An image analysis module detects surgicalevents within an image data stream, while an instrument control modulereceives surgical events detected from the image analysis module andpotentially other sources and generates responses to the detectedsurgical events. The instrument control module processes responses andtransmits processed responses in the form of an instruction set. Thesurgical instrument receives and executes instruction sets communicatedfrom the instrument control module during the surgical procedure.

The present design dynamically adjusts parameters applied to a surgicalinstrument, such as an ocular surgical instrument, detects surgicalevents from image data collected by a surgical microscope focused on asurgical procedure, establishes a desired response for each detectedsurgical event, delivers the desired response to the surgical instrumentas a set of software instructions, and alters the surgical procedurebased on the desired response received as the set of softwareinstructions.

The design presented herein and the specific aspects illustrated aremeant not to be limiting, but may include alternate components whilestill incorporating the teachings and benefits of the invention. Whilethe invention has thus been described in connection with specificembodiments thereof, it will be understood that the invention is capableof further modifications. This application is intended to cover anyvariations, uses or adaptations of the invention following, in general,the principles of the invention, and including such departures from thepresent disclosure as come within known and customary practice withinthe art to which the invention pertains.

The foregoing description of specific embodiments reveals the generalnature of the disclosure sufficiently that others can, by applyingcurrent knowledge, readily modify and/or adapt the system and method forvarious applications without departing from the general concept.Therefore, such adaptations and modifications are within the meaning andrange of equivalents of the disclosed embodiments. The phraseology orterminology employed herein is for the purpose of description and not oflimitation.

What is claimed is:
 1. A method for dynamically adjusting parametersapplied to an ocular surgical instrument, comprising: performing edgedetection and pattern recognition analysis on image data collected by asurgical microscope in real-time to detect a first type of surgicalevent during an ocular surgical procedure; monitoring one or more inputparameters and one or more operating conditions directly from one ormore sensors of the ocular surgical instrument in real-time to detect asecond type of surgical event during the ocular surgical procedure;establishing a desired response for one or more of the first type ofsurgical event and the second type of surgical event; delivering thedesired response to the ocular surgical instrument as a set of softwareinstructions; and altering the ongoing surgical procedure based on thedesired response received as the set of software instructions.
 2. Themethod of claim 1, wherein altering the ongoing surgical procedurecomprises dynamically adjusting the one or more input parameters duringthe procedure.
 3. The method of claim 1, wherein the performing edgedetection and pattern recognition analysis identifies changed conditionsduring the ocular surgical procedure.
 4. The method of claim 1, whereinthe ocular surgical procedure comprises a phacoemulsification procedure.5. The method of claim 1, wherein the one or more input parameterscomprise vacuum pressure, power level, flow rate, and foot pedalposition.
 6. The method of claim 1, wherein the one or more operatingconditions comprise pressure applied, pressure available, vacuumpressure, power level, flow rate, and instrument temperature.
 7. Themethod of claim 1, further comprising: synchronizing a temporalrelationship between the first type of surgical event and the secondtype of surgical event.